HomeMy WebLinkAboutBuilding Permit #00-0178
4. OWNER
fllr-1Jsw
5. ARCHITECT
It AJ 0 Ll:. a)
6. BUILDER
1::i..AJJ.s ~V
7. TYPE OF WORK
New Construction-"
Chimney a Misc.
8. PROPERTY AREA OR ACRES 9. PROPERTY DIMENSIONS 10. CULVERT SIZE 17. COMPLETION DATE
Sq. Ft. II, 01 t Width / () 1 Depth J '-- S Yes No I< 7 - IS - t:> c::>
I hereby certify that I have furnished infonnation on this application which is to the best of my knowledge true and correct. I also certify that I am the owner or authorized agent for
the above mentioned property and that all construction will confonn to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
building official can revoke this pennit for just cause. Furthennore, I hereby agree that the city official or a designee may enter upon the property to perfonn needed inspections.
Amount Brought Forward .................. $
Park Support Fee ............. .............. $
SAC .. .. .. . .. .. .. .. .. . .. .. . .. . .. .. .. .. .. .. ... $
Collector Street Fee . ... .. .. . .. .. . .. . . .. ... $
Sewer Tap ......... ........ .................. $
License Check Fee .. ..~........... ...... $
Pressure Reducer .... ..-:le................ $
Meter Horn................................... $
~
~i~R~fr;~
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2. SITE ADDRESS
J74~ ItIJJl:}&.-wct)j)
3. LEGAL DESCRIPTION
LOT II BLOCK J/.
ADDITION fA} I:> 6-J) t:... c" 4) 9 E,; ~ A T~ .31.J ..
1. DATE
3 .- ~c -
e6
ZONING
K/
II 0. u-l-r-
prD 25-3/7- [">32--Q
A-o ~I
(Name)
toM.S~ ~AI
(Name)
.S ~.i+ Al t[t P E-L
(Name) (Address)
C~AJS.-r;~. ~131 Afltctfl.t UJ/.
Fireplace a Septic a Deck a
Alterations a Addition a Finish Attic a
(Address)
toM-{II-M\I'
(Address) <<
(Tel. No.)
(Tel. No.)
(Tel. No.)
95..-s... r '7 t/..3 - .::J.. ~ S...5
Re-roofing a Porch a
Re-siding a Finish Basement a
x
Signature
license No.
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION Cf1} ()()(). C2.O
USE OF BUILDING
SPD
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R S U
Division 1 2 3 4
City:
Pennit Fee ................................... $
8..e1.r,c
5,)~ , r~
~~.SC>
~b~OO
I 00.00
35, s-o
~~J
Plan Checking Fee . .. . .. .. .. . .. . .. . .. . .. ... $
State Surcharge ............................. $
~.......11.~.J1.b..AG... $
~tie EI~91em .P.lb~.................. $
Other ...........S~................ $
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No. BP 00-0/18
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Her~ I (Widt~4~J.DePth)" 10
12. NO. OF STORIES I./'
14:1.
13. TYPE OF CONSTRUCTION
r-f-A-f'\~
14. FLOOR AREA APPORTIONMENT USE
11..5~
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16. PROJECT COSTNALUE
Date
MATERIAL FILED WITH APPLICATION
SOIL TESTS a ENERGY DATA a
PILING LOGS a PERCOLATION TESTS a
PLANS & SPECS a
SURVEY a
SETS
COPIES
PLOT PLAN
a
~so. ~
4JCD · Of::)
t.fS .oe
.~
(C - /1f{
The eeRIer of Ihe L.ke CouRlry
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
/1; --t'
. //' / /L > .~
~ -.. .....
I
'-.:> / .
--~.; I ('
''-''17,./
',,' , /'--- .
/
I ,/
I (/
.I
The Building, Engineering, and Planning Departments have reviewed the byilqing fE1rFflJf
application for construction activity which is proposed at: (} ,I) . I ,I Y
/ ' / ----;;- (' .. , ) I I
/.'.c.-/ ~ _ v.' " / ,(~',)(!:7 (~~ I V (i..f.-" . .'
Accepted
v
Accepted With Corrections
Denied
Reviewed By: /~ i)~-
Date:
5 r- ~D~ 6f:)
Comments:
t-l/( F, ~~ y{Jv~ fA)~ &ti
0~ \:v~~ I~ ~ \Jkv f.Z..C).tJ l'D Cu/b"
\'
liThe issuance or granting of a permit or approval of plans, specifications and
computations shall not be construed to be a permit for, or an approval of, any violation of
any of the provisions of this code or of any other ordinance of the jurisdiction. Permits
presuming to give authority to violate or cancel the provisions of this code or other
ordinances of the jurisdiction shall not be valid."
~
/7) - (7 r/
Tht' Ct'ntt'r of tht' Lakt Country
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
/-I/lNSSN CtJ/lJ~'IK-.
3/2-0/(10
I I
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/7L/Z0 ,.e,I066 woofl ~{.
Accepted
Accepted With Corrections -><
Denied .......
Reviewed By\-d2l?r ~
Comments:
Date: 3 - :2~"" ~
I.. ~ea&- ll'-l a.1ta~ ltl~k
liThe issuance or granting of a permit or approval of plans, specifications and
computations shall not be construed to be a permit for, or an approval of, any violation of
any of the provisions of this code or of any other ordinance of the jurisdiction. Permits
presuming to give authority to violate or cancel the provisions of this code or other
ordinances of the jurisdiction shall not be valid."
..t
Job Address /'7iJt rJ)4-~r
/.
Heating Contractor I Controlled Air
Name of Tester ~
Date P//~
Percent 02 5:7
.
Percent CO2 "./
Percent CO 0
Stack Temp. 3~)
"
..~
(t~/\ \~\
,~/ . \ ~
~NEr:P
GREEN - FILE
YELLOW - APPLICANT
GOLD - CITY
S.W.No. (Ju - on;
CITY OF PRIOR LAKE
SEWER AND WATER PERMIT
APPLICANT: 0 ILl:r I+bt. f)(C.
ADDRESS: I Co " j? .J OpLX-J l..VA'1 ( L k Ul.)
SIGNATURE: \. ~, \0......0-"
SITE ADDRESS: ,,1{2G:, R~i>c.t iA.)oc.o C J- .
FILL IN THE BLANKS
1. Estimated length of water service
, \
2. Size of water service
I
inch(es) .
3 .
Location of any couplings from structure
4. Type of sewer pipe. ABS PVC K
l{OI
5. Estimated length of sewer line
6. Clean out (if required), located at
structure.
This application
es your permit when approyed./
DATE: 3/~, {n.J
, ,
------------------
------------------
NOTE:
Sewer and Water
contractors must
be registered
with the City.
PHONE: ~ ~.1 -, ~ b t
DATE:3)J..J()(J I
BLDG. PERMIT # (flJ'(,\ 17 (,
PID#-.Z~ - ~rl'- O:Z~-()
,
,/Jor pJ~
,
40
feet.
-.
feet.
Cast Iron
feet.
feet
from
--------------------------------------------
--------------------------------------------
BY
---------------- -------------------------------------------------
---------------- -------------------------------------------------
FEES:
$
$
$
35.00
.50
35.50
Sewer and water line connection permit.
Surcharge
TOTAL
* Fee for either sewer or water individually is $t1~ plus
$ .50 surcharge.
* Sewer and water permits issued for new construction must be
recorded on the building permit card at the time of issuance
to insure that no duplicate sewer and water permits are
issued.
DATE PAID
RECEIPT #
REC'D BY
AMOUNT PAID
16200 Eagle Creek Av. S.E., Prior Lake, Minnesota 55372 / Ph. (612) 447-4230/ FAX (612) 447-4245
An Equal Opportunity Employer
~~i ri!!99 f CITY OF PRIOR LAKE Me t'{
'S ~ ~ ~ 16200 EIg'. Creek Av. S.E. P8Iml' No. ()t) - 0 l'7 ~ LJ
~ Prlar Lake, UN 55372 -. Y
~ HEATING APP UCATI ON , PERMIT ,( S"vIe F....'
"..-"" ,.../ ~ . f U ConmeJclel
Oal. c:J - 2) -l..A-.J PfD . . ~S ... :S(1 - 03~ - ()
R,rlhPIA.,~O (;/-.
lot J \ Block Ll Addla. W~cAoA Q./ ~l b
OW......N.... ~A~P^) - r;.A1.~' 6
Sill Addlesl /7 -if ~ C,
TYPE OF STRUCTURE
/"
1\YQ.Famly
111_.111.'
I. an-
I. ,..
..,
o...w
Pubic
Mulll-F""
Oller
~
c.n
"-
~
c.n
"-
~
~
Fe. Behlour.
$~ A{{tVlnduSIJR'. Commerd-' " MuI1I-Famly
R..ldIRGal. H.aU"g & AC
Re.ldent.l. He.11ng O"1f
R.sIdenllaf. Gal Fiteplac.
ReskllRtt.'. Addillofts I Aller.Uo..
R_denllal, AC Only
Addl... .
Heating OontaclOr C~)Wk ~ (l/f ,r
Addre. f;)ffJl (') 61 ~ IJ A ~,
Tel.phone' , ~t;o - ~~.=l
FurftaceMat.'ModII ~Ale. " ~~TYPEOFSYSTEM
, , W..m Ak PlaRlt
Modit Sill 7{Jx f)~ Cq ~ Gravhy
M.chanicll
AIr Candkionlng ~
v.nl Spt.m V~AJ,JHfl~
HeAnNQORPOWERP~T
51,am
Hot W.tOl
Radia1lon
Spedal D.vlce. .
Conn. load .
Fue1 A/HI- Flue Sill PlJt_
q
A.lum Operir1gl. t/
Input ,r:f' .~~ OUtput c:5'~ ~nn
t .
SvJJPI~ Oplrintl
Ed,.
OtMI Dlfce.
Cfm.
TYPE OF WORK
v
Met.Uon.
Replaclmlnt New Construction
Etl. Camp. 011. ,
. Ivldlng P.""., .
Rlpalr
&t. CoI' I
(jl) -()\1'6
HEAlING PERMIT FEE1
STAlE SURCHARGE .
roTAL PERMIT fEES ,.
.50 ~
Aec.~, .-< .,
1% 01 Job coil (81.60 ..........)
119.60
Se4.50
sal.50
139.60
hl.50
.....
VJ
~
I\J
MAY
5 2fXXJ
n
o
Z
-i
AJ
o
r
r
m
t:I
D
-
AJ
R.membl' '0 Idd Ib, Sllll Surch... en 11. bolom oj ... .pplicllloa.
The pdce or '0.' h..llng pennh Includea on. lOuth-in and an. IinIIln.....n.
Addllionallnspectionl wi be billed ., 135.00 each.
Hou'8 BeaUn" TaM RecDfd musl'" "'ttd wJth bulldlna DlJDJlIIIIdIH..... buld-
In, c.....ic.'. 01 occupancy wit b. luued. .
HF4T ~~, ~UI ATIQHI qr.flW8EIl wIOI numb.. of Iupplr and fe1urn apInInglllted per
.oom wilh CFM., per OPining. NI. atructvru or adclllons ..nd....r ,... wlhtuppl,
end "'un, locallonl aIMJwn. HEAT lOSS CAlCUlATIONS. PAYMEtn' AND-
^PPlICATIONS M^Y BE MA'LEO TO THE CITY OF PRIOR lAKE. ,.. EACI.E
CAEt:k AVE. '::.1= PRIOR LAKE', MN 55372.-
Cftr Hal buslRe.. hours ar.8 a.m. · 4:30 p.m.
ALL WORK MUST 8E INSpeCTED (ROUGH.1M AND FINAL) · CALL an' HILL
441-4230
ffl
D
-i
-
Z
Gl
D
Z
t:I
D
I
n
+
(TI
.....
I\J
~
~
...J
~
I\J
~
c.n
I he,eby .pply tor 8 mlchllnlca'.yalem. permU and I .cftnGWI.....ltllllh.
Inlorm.'lon aboye'l Clomple'. ltUlaccur.'.; ltal Ih. work wm.. ..........m.noe
wUh Ihe ordinance. and cad.. of It" eRr Ind with 'he .lltl "'I""',,~~n'o"
cod..: Ih.t thl. lo,m doe. not become a p.rmlt un'" II,n.. br ... 8Ul.DINB
. OFFICIA~ 111.' Ihe work win b, In Icc:ordance with the .,pm" ....." the
! ca.e 01 all wa.k whlGh requl... .evlew Ind approYaI 01 pi....
Zoh ft7~. - -
I, ""pIc,.... Igna''r. ~
/1~ ,;.tll~, 'I 1.'/ -' 1"1"" t!."~,, )
(j Nr"~
_Z
P
VJ
...J
...J
r'~ .~tr)
.....
. (~ rJ9-(j()
a.II
~
~
.....
,
- -, ~~~-~ "~,--_~ , i.,..r'
CITY OF PRIOR LAKE
PLUMBING PERMIT PPNo. ro- ()}7~
Applicant Ma#hpu) ~njItJ.s, Inti,. Phone:~SI) ~c:2.3 - d7,-~t)
Address: jff~O (Jof'rouse) ~, .~ern~. MN .s.s-()~K
Signature: 11.A r ' '-nI.~~
Legal De~criPtion. Lot '--j ~ Slack U 4 sUb...wooelr1d(ML.
Site Address:_I'7~ cJ?;Ai CdLI~ ~r 0 -
Building Permit # 0?~I''1 Y PIO # ~S--~I'1- os;?-o
NOTE: This permit will not be processed without complete information.
FIXTURE UNITS
1. Blue
1. Gold
J. Ydlow
file
Clty
AppIiCUlt
00
n. CftU<< ., t'" Lak. COUfttry
MAY - 9 ml
Quantity Type of Fixture Quantity
/ 8ath Tub with or without shower 3
I Dishwasher /
/ Floor Drain
/ Lavatory (bathroom sink) /
I Laundry Tray (1 or 2 compartment sink)
I Shower Stall
I Sinks
Bar Sink
I Water Closet (toilet)
Type of Fixture
Rough-ins
Water Heater
Water Softner
Stand Pipe (washing machine)
Sewage Eje'ctor
8acktlow Assembly (RPZ, Double Check. P'I::
Backflow Assembly Test
Lawn Sprinkler
Other
FEE SCHEDULE
Industrial, Commercial & Multi-Family
(1 %, of job cost. $39.50 minimum)
Residential, New One & Two Family
Residential, Additions & Alterations
State Surcharge
$99.50
$39.50
$
$ qq.5()
$
$ .50
GRAND TOTAL
$ 1M. tieL 'z1 ~.
This permit is granted upon the express condition that said
contractor, shall comply in all respects with the ordinances
of th~ State Pl~mbing Cod d the JIll d~nts thereof.
" 1 RE NO..) j 0 DATE
---1 ~ \ . ,,' Al1cST
f or all insp lions 24 bours in advance.
16200 Eagle Creek Av. S.E., Prior Lake, Minnesota 55372/ Ph. (612) 447-4230 / F.AJ( (612) 447-4245
An Equal Opponunicy Employer
,
PRIOR LAKE
INSPECTION RECORD
DEPAF\TMENT OF
BUILDING AND INSPECTION
SITE ADDRESS 17L 9J.D ~ Q ~ .
NATURE OF WORK Ne.w ~
USE OF BUILDING ~FD
PERMIT NO. ()1)- OIZf') DATE ISSUED 3-2:S--20olJ
CONTRACTOR ~~ ~.
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
FOOTING
h INSPECTOR
DATE
6/4/1)1)
, ,I
FOUNDATION (Prior to Backfill) . ~, 51lt/ob
PLACE NO CONCRETE UNTIL ABOVE HAS BEE/N ~IGNED
ROUG~ - INS (
SEWER I WATER I SEPTIC \~ . ~.., ~ / e 2, f ~
FRAMING t!y I . fp 1,341
INSULATION '9 b ,13. "1r!c/lJ / /
ELECTRICAL ~ _ V
PLUMBING I( f)~ "!It/Ill
HEATING (if required) I (/ (j, J oil 41 6""0
FIREPLACE I / )
GAS LINE AIR TEST ,~ (J> 4)J'l!J) I
COVER NO WORK UNTIL AfoVE HAS BEEN SIGNED
~
GRADING (Prior to Sodding)
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT OCCUpy UNTIL ABOVE HAS BEEN SIGNED
NOTICE
This card must be posted near an electrical service cabinet prior to rough-in inspections
and maintained until all inspections have beeD apprraved. On buildings and additions
where no service cabinet is available, card shall be placed near main entrance.
FINALS
61('
. ~
'f. J.I)
.....,
tfr;r,
/!i:r ./
I I
Yly/trI
P/1/~
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (612) 447-9850
4,
HOUSE HEATING TEST
ADDRESS f7V~ jQ.J~ ~ ~ r
OCCUPANT
HEAT LOSS
SOLD BY
Electrical Wark By
TYPE OF HEA T
DA TE HTG. INST.
GA
.FAJ/HW
c: GAS DESIGN
MAKE _I;~,
Mod.1 1""u~r);. a,~c; oJo
Serial pc,r.,t; Y13'..b~
INPUT -I'-r;, ~
~
THERMOSTAT
Va Ive _
Limit
limit Setting
Fan Setting _
Pilot Type
Pi lot Male.
Pilot Model.
Pilot Timing
L. W. Cut Off
Pressure "5;, S-
o "
Input CFH
Stack Temp. "J.J:5'"'
Form 235
CONTROLS
Heat Plug
-~
P.rcent CO2 -;;7
Percent 01 y; '7
Percent CO ~
RECORD
.APT.
OWNER.
FLOOR
STEAM
INSTALLED BY CONTROLLED AIR
Gas line By CONTROLLED AIR
SPACE HTR. UNIT HTR. '
MAKE OF BURNER
Mod.1 _
Mo.. BTU Rating
MAKE OF FURNACE
Mod.1 _
Vent Size ~
KIND OF LINER
Draft Hood
_ Fi It.... Size
o..lmney Location ~s.ide
Chimney Construction to \ ~
Smoke Bomb
Draft
Door Pr..sure_
Date Te.ted ~/ ~
Company T.sfing CONTROLLED AIR
Name of Te.ter ~
CITY / ./
OTHER
CONVERSION
. SIZE.
RegulaTor
Number,
_ Outside
. Wiring
T.st Tag
Lightint Inst.
SUBURB
.NONf
TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
tl ~ (fl)
ADDRESS llA 2..G
OWNER
PHONE NO.
PERMIT NO.
() -/78
o FOOTING 0 PLUMBING RI 0 EX/GRAD/FILLING
o FOUNDATION 0 MECH RI 0 COMPLAINT
o FRAMING 0 WATER HOOKUP 0 FIREPLACE RI
o INSULATION 0 EWER HOOKUP /1A\) 0 FIREPLACE FINAL
~FINAL LUMBING FINAL' (t;; 0 GASLlNE AIR TST
o SITE INSPECTION 0
CO~TS:(D) ~...J';.""':~ ~
t:> ~ ~ rdtrtn. ~ t;(,a( tAd- ~ ~
~~ ~ ~ ~ p~"-t.JL ~
lJ-L ~ ~ ~/B: ~~
@ ~~~ +-15~ 'f<, ~
~ ~ ~ -fNZ>lc t'>-::1 .~
'~. ~ ~ t:#IrtL
~~~~~
_' _ _~AA"~ /J {/ U
~~
~~~~
(t~ ~ ~ ~ tA- ~ WrJ-RL ~
~:~~1(q-~. ~.~
7~ ~ ~~.
uk:tl;v rvt.itLN .- ~ - tJ~ ~. ~. - ~
.
o WORK SATISFACTORY, PROCEED ~
~ CORRECT ACTION AND PROCEED
)( CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING t5(&j'
~ -- ~ -
Inspector: ltJ.,.f- ~ Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
DATe TIME
CITY OF PRIOR LAKE 52'Z~ 1\ ~ CD
INSPECTION NOTICE SCHEDULED
ADDRESS \/42Co ~ewecJ. Gt-
OWNER CONTR.
PHONE NO. PERMIT NO. 0- t7f{
o FOOTING 0 PLUMBING RI
o FOUNDATION ~ ~ECHRI
o FRAMING 't:Y WATER HOOKUP
o INSULATION IFJ) WER HOOKUP
o FINAL ~ 0 PLUMBING FINAL
o SITE INSPECTION 0 MECH FINAL
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
Q
COMMENTSm ~ ~~o-.-J f' fQ
0v/1 4J2j-~ ~ ~.
(j
f //5
t(4l( ~v
~ l-l~\ , ..
tf1' ~ /~( It l<-"~ - f\.tS
. ~ ~~~.;-?~' uA-,
11( 11/6 ~ '-/0 ~
{~~. - 5~A((( J1L-.
~ WORK SATISFACTORY, PROCEED
~. CORRECT ACTION AND PROCEED
o CORRECT WORfitK CALL FOR REINSPECTION BEFORE COVERING
Inspector: I Owner/Contr:
I
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
INSNOTl
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED e -Z I }K.5 g :-co
~-&j<-wcxrl G-
CONTR.
ADDRESS l14 ~
OWNER
PHONE NO.
PERMIT NO.
0-/78'
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
SEWER HOOKUP
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
(fJ) MECH FINAL
COMMENTS: M.t.d- - ~ ~
(!i~ ~ ~ ~ F:{>, ~
~ ..:x:* A:T-, ~ ~ U---4,J) ,
@~~~~-r-~
(/ "-.J
1"'- __ fJ /) _ (I ,
p~~
o WORK SATISFACTORY, PROCEED
~ CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
~
.J
Inspector:
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
INSNOTI